Empty Bursa SIGN: Significance in arthroscopic sub acromial decompression - an audit of consecutive patients 2003 to 2020.

OBJECTIVE

To establish a relationship between sub acromial bursa and shoulder impingement by determining its presence or absence in sub acromial space. To determine the novel prospects and favourable outcome after surgery in shoulder impingement syndrome.

METHODS

Over 1000 patients with the diagnosis of shoulder impingement were studied from 2003 to 2020 at Manor Teaching Hospital, Walsall, UK. During Arthroscopy, the findings were noted and documented. The sub acromial bursa and its presence or absence was noted along with kissing lesion of supraspinatus confirmed at Arthroscopy. Functional outcome in all patients was assessed with q-Dash score and pain relief was documented with VAS (Visual Analogue Scale).

RESULTS

Sub acromial decompression did not completely resolve symptoms in 649(64.9%) patients having adequate bursa and no kissing lesion. Therefore, a cause other than acromion impingement was considered. However, in 351(35.1%) patients without any bursal tissue, sub acromial decompression alone had better results. Mean post-operative q-DASH score in group A (Bursa present) was 49.21±41 and in group B (Empty Bursa) it was 35.73±23. Mean post-operative VAS (Visual Analogue Scale) score in group A was 6.5±2.3 and in group B, it was 4.1±2.1.

CONCLUSIONS

We report that the presence of kissing lesion and an empty Bursal space under the acromion is a high predictor of successful outcome after arthroscopic decompression.